What is Carpal Tunnel Syndrome?
By Laurence Schubert APAM
Carpal Tunnel Syndrome is a common conditioninvolving persistent pain, tingling and numbness in the hand. It is the resultof compression of one of the major nerves in the hand/wrist, the median nerve.
What is the Carpal Tunnel?
The carpal tunnel is an area where varioustendons, blood vessels and nerves run through in order to allow the hand tofunction. The median nerve is the only nerve that passes through the carpaltunnel, and is significantly affected with carpal tunnel syndrome. The flexorretinaculum and bones of the wrist (carpals) make the boundaries of the carpaltunnel. The two other major nerve branches of the hand, the ulnar and radialnerve, do not pass through the tunnel.
Who gets Carpal Tunnel Syndrome?
Approximately 5% of the population havecarpal tunnel syndrome and 1 in 10 will develop it at some point in their life.It is most prevalent between ages 45-59 or 75-84 year olds and females are moreat risk than males.
What causes Carpal Tunnel Syndrome?
As described above, the main cause of carpaltunnel syndrome is the compression of the median nerve. Therefore, anything thatincreases the pressure within the carpal tunnel can contribute to the cause ofthis syndrome. Often the exact cause is unknown (idiopathic) and multifactorial.The following may contribute to the cause of carpal tunnel syndrome.
· Tendon inflammation
· Hormonal changes - e.g.hypothyroidism, menopause and pregnancy
· Diabetes Mellitus
· Obesity
· Oedema/swelling
· Repetitive manual activity
· Auto-immune disorders suchas rheumatoid arthritis
· Acute trauma to the wrist
What are the Symptoms of Carpal Tunnel Syndrome?
In the initial phases of carpal tunnelsyndrome you will experience intermittent and nocturnal neural symptoms of paraesthesias(tingling) and numbness. As the condition progresses, this will become morefrequent and occur during daylight hours. As well as neural symptoms, pain isoften present and in severe cases will radiate proximally to the forearm, upperarm and even shoulder. In cases of true carpal tunnel syndrome you will notexperience any neural symptoms above the wrist. Most commonly you willexperience numbness in only the palmer surface of your first 3 fingers.However, as the condition worsens, other nerves can become sensitised, leadingto the entire hand becoming numb. It is likely that you will begin to losestrength of your hand and finger muscles.
Can your Physiotherapist diagnose CarpalTunnel Syndrome?
They certainly can. Diagnosis of carpaltunnel varies depending on your health practitioner’s preference. The mostimportant diagnostic factor is clinical assessment, which includes an accuratehistory of your condition. Following this, it is debatable whether nerveconduction studies are necessary or not. Often nerve conduction studies willconfirm that you have carpal tunnel and give you information regarding the degreeof the condition. E.g. determining degree of demyelination and axonal loss thathas occurred. However, in many cases it is not necessary and is better forruling out conditions, as appose to diagnosing them.
How do you treat Carpal Tunnel Syndrome?
If you have any questions about carpal tunnelsyndrome please contact us or book online for an appointment.
